113 articles - From Friday Aug 23 2024 to Friday Aug 30 2024
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Am J Gastroenterol |
|---|
| Gastrointest Endosc |
| Hepatology |
A narrative review of lifestyle management guidelines for metabolic dysfunction-associated steatotic liver disease. Most guidelines recommend weight reduction through physical activity and improving nutrition, as these have proven positive effects on health outcomes when sustained. However, gaps regarding mental health and the social and environmental determinants of MASLD were found. To optimize behavioral modifications and treatment, we recommend carrying out studies that will provide further evidence on social support, environmental factors, and mental health, and further exploring DHIs. |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
|---|
Systematic review: Mortality associated with raised faecal immunochemical test and positive faecal occult blood results. All-cause, non-CRC and cause-specific mortality appear higher in those with raised f-Hb. Population-based studies are warranted to elicit whether this association occurs in symptomatic patients. |
| Clin Gastroenterol Hepatol |
Comparative Efficacy of Biologics and Small Molecule in Ulcerative Colitis: A Systematic Review and Network Meta-analysis. Upadacitinib appears to be superior to other therapies in achieving clinical remission, endoscopic improvement and remission, and histological remission. Furthermore, novel biologics such as risankizumab and guselkumab ranked high in achieving these outcomes. This study highlights the efficacy of small molecule drugs and novel selective IL-23s as alternatives to other biologics. |
| Gastrointest Endosc |
Efficacy and Safety of Gastric Peroral Endoscopic Myotomy Across Different Etiologies of Gastroparesis: A Systematic Review and Meta-Analysis. Based on this meta-analysis, G-POEM is effective and safe for treating refractory gastroparesis irrespective of the etiology, with significant improvements in clinical success rates and GCSI scores. |
Efficacy of Different Steroid Therapy in Preventing Esophageal Stricture after Endoscopic Submucosal Dissection: A Comparative Meta-analysis. This study suggests that combined administration appears preferable for preventing esophageal stricture in patients post-ESD, and steroids could enhance stricture prognosis. However, due to the lack of large-sample RCT studies comparing different steroid administrations, more high-quality research is necessary to confirm these findings in the future. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
|---|
Enhancing linkage to care for hepatitis B, D, and C patients: A retrospective-prospective study. Among patients with viral hepatitis who required appropriate specialist care and were eligible for contact, 64% with HBV, 100% with HDV and 27% with HCV were successfully reintegrated into care. Overall, 324 (47.2%) eligible patients were linked to care, indicating the success of this strategy. |
Long-term clinical outcomes of extracorporeal shockwave lithotripsy and endoscopic retrograde cholangiopancreatography for pancreatic duct stone treatment in patients with chronic pancreatitis. P-ESWL and ERCP are effective and minimally invasive treatments for pancreatic stones in patients with painful CP. Most patients achieved complete pain relief, and pain-type conversion was common after treatment. (ClinicalTrials.gov NCT05916547). |
Racial and ethnic disparities in post-liver transplant outcomes for patients with acute-on-chronic liver failure: An analysis of the UNOS database. Black patients experienced the poorest outcomes and Hispanic and Asian patients demonstrated more favourable outcomes compared to Whites. |
The contribution of dietary advanced glycation end-products and genetic risk in the development of inflammatory bowel disease: a prospective cohort study. Dietary CEL was associated with an increased risk of IBD and CD, but not UC. Further interventional studies are required to support the potential benefit of AGE restriction, especially for individuals at a high genetic risk of CD. |
| Am J Gastroenterol |
Acceptance & Commitment Therapy for Adults Living With Inflammatory Bowel Disease & Distress: A Randomized Controlled Trial. Both programs were of benefit to people with IBD and distress. However, ACT offers a significant added benefit for HRQoL and self-reported Crohn's disease activity and may be a useful adjuvant therapy in integrated IBD care. |
Clinical and biological perspectives on non-canonical esophageal squamous cell carcinoma in rare subtypes. Moreover, we leverage the convergence of these diseases on ESCC to identify common mechanisms underlying malignant transformation including aberrant proliferation, mucosal barrier dysfunction, increased inflammation, and genome instability. Herein, we summarize the clinical presentation, pathologic findings, potential screening strategies, and common mechanisms of malignant transformation associated with these rare diseases that drive ESCC. |
Clinical implications of inflammation in patients with cirrhosis. Those patients with the most profound systemic inflammation have the worst prognosis. Systemic inflammation exerts its negative clinical effects via a number of mechanisms including nitric oxide-mediated increased splanchnic vasodilation, immunopathology and metabolic reallocation. |
FECAL IMMUNOCHEMICAL TEST TO DETECT COLORECTAL NEOPLASIA IN LYNCH SYNDROME - A PROSPECTIVE MULTICENTER STUDY. FIT at thresholds ≤ 4.1 μg Hb/g feces may be a promising strategy to postpone colonoscopy in approximately 9 out of 10 individuals with Lynch syndrome. Large validation studies that also provide gene variant-specific outcomes should be prioritized. |
Fecal Proteolytic Bacteria and Staphylococcal Superantigens are Associated with Abdominal Pain Severity in Irritable Bowel Syndrome. In keeping with our preclinical findings, we show that increased presence of SAg-producing S. aureus in fecal samples of patients with IBS is associated with increased levels of abdominal pain. We also show that increased fecal proteolytic activity is associated with increased abdominal pain in patients with IBS. |
Granulocyte colony stimulating factor improves Prednisolone responsiveness and 90-day survival in steroid eligible severe Alcohol associated Hepatitis: The GPreAH Study a randomized trial. Addition of GCSF to prednisolone improves steroid responsiveness and 90-day survival with fewer infections and new onset complications in SAH patients. |
Internet delivered exposure based cognitive behavior therapy for IBS - A clinical effectiveness study. We conclude that ECBT is effective under real world conditions, also when delivered via the internet, and that an important treatment mechanism is the reduction of avoidance behaviors. |
Optimizing Cost-Effective Care for Chronic Constipation in General Gastroenterology Using an Office-Based, Point-Of-Care Test (RED): Cost-Effectiveness and Cost-Minimization Analysis. Point-of-care testing using RED appears cost-effective/cost-saving to triage chronic constipation care in general gastroenterology. |
Oral breathing facilitates endoscopic operability compared to nasal breathing in peroral endoscopy: a randomized controlled trial. OB facilitates endoscopic operability compared to NB in peroral endoscopy. UE with OB is recommended as the preferred choice for unsedated peroral endoscopy in daily practice. |
PHYSIOLOGICAL AND PSYCHOLOGICAL FACTORS CONTRIBUTE TO REAL-TIME ESOPHAGEAL SYMPTOM REPORTING IN REFRACTORY REFLUX PATIENTS. Interpretation Real-time reflux symptom reporting is a multifactorial process, with both psychological and physiological processes contributing to different aspects of the reflux disease experience. Findings build on questionnaire-based research to underscore the importance of including psychological processes in our understanding of esophageal symptom reporting. |
Severe Polypharmacy Increases Risk of Hospitalization Among Older Adults with IBD. Severe polypharmacy was initially present in more than 25% of older adults with IBD and increased to 34% within 4 years of index visit. Severe polypharmacy, as well as PIM utilization among those with polypharmacy, were also associated with an increased risk of hospitalization at one-year, highlighting the need for deprescribing efforts in this population. |
Spine and sacroiliac joint involvement in newly diagnosed inflammatory bowel disease patients - clinical and magnetic resonance imaging findings from a population-based cohort. One-in-six newly diagnosed IBD patients had MRI findings indicative of axSpA. As 40% of these patients were asymptomatic, this suggests that axSpA is underdiagnosed in early IBD. Multidisciplinary collaboration is essential to ensure early detection of axial inflammation and to enable optimal therapy preventing future structural damage and disability. |
Timing of Direct Oral Anticoagulants Resumption Following Colorectal Endoscopic Submucosal Dissection: A Nationwide Study in Japan. Resuming DOACs the day after colorectal ESD was associated with reduced thromboembolic events without significant increase in risk of delayed bleeding. |
| Clin Gastroenterol Hepatol |
Ancestral diversity in pharmacogenomics affects treatment for Hispanic/Latine populations with inflammatory bowel disease. These findings indicate that NUDT15 testing should become standard clinical practice before prescribing thiopurines in individuals with Amerindian ancestry, including Hispanic individuals. Additionally, rs2097432 should not be used as a surrogate for HLA-DQA1*05 testing for diverse populations. Ultimately, incorporating ancestry in personalized therapeutic approaches is important for treatment of Hispanic patients with IBD. |
Baseline viral load and on-treatment hepatocellular carcinoma risk in chronic hepatitis B: A multinational cohort study. Baseline viral load showed a significant, non-linear, parabolic association with HCC risk during antiviral treatment in noncirrhotic CHB patients. Early initiation of antiviral treatment based on HBV viral load may help prevent irreversible HCC risk accumulation in CHB patients. |
Decreasing Case Fatality Rates for Patients with Cirrhosis Infected with SARS-CoV-2: A National COVID Cohort Collaborative Study. In this N3C study, we found that the observed 30-day CFR decreased progressively for both CLD patients with and without cirrhosis, consistent with broader trends seen in the general population. |
Effects of intermittent calorie restriction in non-diabetic patients with metabolic dysfunction-associated steatotic liver disease. The ICR diet reduced LFC more effectively than SOC in patients with MASLD, particularly in patients with obesity. Additional studies are warranted in larger and more diverse cohorts. |
Emergency Department Utilization and Outcomes among Adults with Cirrhosis from 2008 to 2022 in the United States. Patients with cirrhosis have higher ED utilization and almost 2-fold higher post-ED visit mortality than CHF and COPD. These findings provide impetus for ED-based interventions to improve cirrhosis-related outcomes. |
IL-1 Signal Inhibition in Alcohol-Related Hepatitis: a randomised, double-blind, placebo-controlled trial of canakinumab. CAN therapy in severe AH participants with MELD≤27 did not alter biochemical or clinical outcomes compared to PBO. Non-significant histological improvements did not translate into clinical benefit. |
Persistence of Lugol-unstaining is associated with an increased risk of progression to malignancy in the esophagus. The persistence of LULs is associated with progression to malignancy in the esophagus, even in individuals without dysplastic lesions. Based on this, a more efficient post-screening surveillance strategy could be established. |
Role of early on-treatment serum HBV RNA declines in predicting hepatocellular carcinoma risk in patients with chronic hepatitis B. Serum HBV RNA declines at year 1 and 2 were significantly associated with on-treatment HCC risk. Incorporating early on-treatment HBV RNA declines into HCC risk prediction models can be useful tools to guide appropriate surveillance strategies in NA-treated patients. |
Travel Time to Treating Center is Associated with Diagnostic Delay in Pediatric Inflammatory Bowel Disease. Consistent with prior literature, diagnostic delay is longer for CD than UC. Reassuringly, time to diagnosis is equitable across racioethnic groups. New models of diagnostic care are needed for communities affected by longer travel times. |
| Endosc Int Open |
Endoscopic ultrasound with tissue acquisition of lymph nodes in patients with potentially resectable intrahepatic cholangiocarcinoma. In patients with potentially resectable iCCA and suspicious LNs on cross-sectional imaging, EUS-TA confirmed LN involvement in 30% of patients. Surgical exploration was withheld mostly because of extraregional LN involvement and regional LN involvement in patients with high surgical risk. |
| Endoscopy |
Can optical evaluation distinguish between t1a and t1b esophageal adenocarcinoma: an international expert inter-observer agreement study. Expert Barrett's endoscopists can reliably differentiate T1a/T1b oesophageal adenocarcinoma from HGD. Although there is fair-to-moderate agreement for T-staging, T1b disease cannot be reliably distinguished from T1a disease. This may have implications on clinical decision making and selection of endoscopic treatment methods. |
| Gastroenterology |
Crohn's patients and healthy infants share immunodominant B cell response to commensal flagellin peptide epitopes. These findings identified a distinct subset of CD patients, united by a shared reactivity to a dominant commensal bacterial flagellin epitope that may represent failure of a homeostatic response to the gut microbiota beginning in infancy. |
Glutamine supplementation as a novel metabolic therapeutic strategy for LIG3-dependent chronic intestinal pseudo-obstruction. LIG3 deficiency leads to mitochondrial dysfunction. High levels L-Gln supplementation was beneficial in LIG3-mutant cells and improved symptom severity without noticeable side effects. Our results provide a proof-of-concept to design ad hoc clinical trials with L-Gln in LIG3-mutant patients. |
Recompensation of Chronic Hepatitis C-related decompensated cirrhosis following direct-acting antiviral therapy: Prospective Cohort study from an HCV elimination program. SVR-12 in HCV-related decompensated cirrhosis in a predominant genotype 3 population, led to recompensation in 24.7% of patients over a follow-up of 4 years in a public health setting. Despite SVR-12, new hepatic decompensation evolved in 19% and HCC developed in 2.9% of patients. |
| Gastrointest Endosc |
Evaluating no fixation, endoscopic suture fixation, and an over-the-scope clip for anchoring fully covered self-expanding metal stents in benign upper gastrointestinal conditions: a comparative multicenter international study (with video). Stent fixation using OTSC is safe and effective at preventing stent migration and may also result in improved clinical response. |
SHORT ESOPHAGEAL MYOTOMY VERSUS STANDARD MYOTOMY FOR TREATMENT OF SIGMOID-TYPE ACHALASIA: RESULTS OF AN INTERNATIONAL, MULTICENTER STUDY. POEM with short myotomy is effective and safe for the short-term treatment of sigmoid and advanced sigmoid achalasia. Short myotomy may lead to less reflux than standard myotomy. |
Success Rate of Fiducial Markers Placement for Treatment of Esophageal or Rectal Cancers, a prospective multicenter study (FIDECHO study). This prospective multicenter study highlights the safety and high success of the placement of fiducial markers under EUS, for rectal and esophageal tumors, without adverse event, and with a short procedure time. Fiducial markers remain in place over time during radiation therapy. ID NCT03057288. |
| Gut |
CD64+ fibroblast-targeted vilanterol and a STING agonist augment CLDN18.2 BiTEs efficacy against pancreatic cancer by reducing desmoplasia and enriching stem-like CD8+ T cells. Vilanterol plus the STING agonist sensitised PDAC to CLDN18.2 BiTEs and augmented efficacy as a potential novel strategy. |
| Hepatology |
A functional genomic framework to elucidate novel causal metabolic dysfunction-associated fatty liver disease genes. Complementary genetic and genomic approaches are useful for the identification of MASLD genes. Our data supports VKORC1 as a bona fide MASLD gene. We have established a functional genomic framework to study at scale putative novel MASLD genes from human genetic association studies. |
Cholangiocyte ciliary defects induce sustained epidermal growth factor receptor signaling. This study's findings shed light on ciliary function and robust EGFR signaling with slower receptor turnover. We could use therapies that restore the function of primary cilia to treat EGFR-driven diseases in PLD and CCA. |
Human induced pluripotent stem cell based hepatic-modeling of lipid metabolism associated TM6SF2 E167K variant. Our findings indicate that induced hepatocytes generated from iPSCs carrying the TM6SF2-E167K recapitulate the effects observed in human hepatocytes from individuals with the TM6SF2 mutation. This study characterizes an in vitro model that can be used as a platform to identify potential clinical targets and highlights the therapeutic potential of targeting protein misfolding to alleviate ER stress and mitigate the detrimental effects of the TM6SF2-E167K mutation on hepatic lipid metabolism. |
Incidence of liver complications with hemochromatosis associated HFE p.C282Y homozygosity: The role of central adiposity. In p.C282Y+/+ males and females, increasing WHR is associated with substantially higher risks of liver complications. Interventions to reduce central adiposity to improve these outcomes should be tested. |
Mdka produced by the activated HSCs drives bipotential progenitor cell redifferentiation during zebrafish biliary-mediated liver regeneration. The activated HSCs produce Mdka to drive the redifferentiation process of BP-PCs through activating Erk1 during the biliary-mediated liver regeneration, implying previously unappreciated contributions of nonparenchymal cells to this regeneration process. |
Optimizing thiopurine therapy in autoimmune hepatitis: A multi-center study on monitoring metabolite profiles and co-therapy with allopurinol. Maintaining CBR in AIH was associated with 6TGN ≥223 pmol/0.2 ml. For patients who fail to achieve CBR and therapeutic 6TGN levels despite thiopurine dose increase due to preferential 6MMP formation, co-medication of allopurinol alongside low-dose thiopurines represents an efficient alternative. |
| J Hepatol |
ACMSD inhibition corrects fibrosis, inflammation, and DNA damage in MASLD/MASH. Our findings highlight the benefits of ACMSD inhibition to enhance hepatic NAD + levels and enable genomic protection, underscoring its therapeutic potential in MASLD/MASH. Impact and implications Enhancing NAD + levels has shown remarkable health benefits in mouse models of MASLD/MASH, yet liver-specific NAD + boosting strategies remain underexplored. Here, we present a novel pharmacological approach to enhance liver NAD + de novo synthesis by inhibiting ACMSD, an enzyme highly expressed in the liver. Inhibiting ACMSD increases NAD + levels, enhances mitochondrial respiration, and maintains genomic stability in hepatocytes ex vivo and in vivo. These molecular benefits prevent disease progression in both mouse and human liver organoid models of steatohepatitis. Our preclinical study identifies ACMSD as a promising target for MASLD/MASH management and lays the groundwork for developing ACMSD inhibitors as a clinical treatment. |
Identifying the optimal measurement timing and hemodynamic targets of portal pressure gradient after TIPS in patients with cirrhosis and variceal bleeding: a prospective cohort study. PPG measured 24 to 72 hours after TIPS correlates with long term PPG and clinical outcomes, and hemodynamic target with a PPG 11-14 mmHg reduced encephalopathy but not compromised clinical efficacy. Impact and implications The optimal timing of measurement and hemodynamic targets of portacaval pressure gradient (PPG) after transjugular intrahepatic portosystemic shunt (TIPS) remains inconclusive. Here we show that post-TIPS PPG measured at least 24 hours but not immediately after the procedure correlated with long-term PPG and clinical events, therefore should be used for decision making in order to improve clinical outcomes. Targeting post-TIPS PPG at 11-14 mmHg or 20%-50% relative reduction from pre-TIPS baseline that measured 24-72 hours after procedure reduced encephalopathy but not compromised clinical efficacy, therefore could be used to guide TIPS creation and revision in patients with cirrhosis and variceal bleeding undergoing covered TIPS. Clinical trial registration |
Targeting the liver clock improves fibrosis by restoring TGF-β signaling. The CC regulates TGF-β signaling, and the breakdown of this control is associated with liver fibrosis in patients. Pharmacological proof-of-concept studies across different models uncover the CC as a therapeutic candidate target for liver fibrosis - a rising global unmet medical need. Impact and implications Liver fibrosis due to metabolic diseases is a global health challenge. Many liver functions are rhythmic throughout the day being controlled by the circadian clock (CC). Here we demonstrate that the regulation of the CC is perturbed upon chronic liver injury and this perturbation contributes to fibrotic disease. By showing that a compound targeting the CC improves liver fibrosis in patient-derived models, this study provides a novel therapeutic candidate strategy to treat fibrosis in patients. Additional studies will be needed for clinical translation. Since the findings uncovers a previously undiscovered profibrotic mechanism and therapeutic target, the study is of interest for scientists investigating liver disease, clinical hepatologists and drug developers. |
Thyroid hormone receptor-beta agonist HSK31679 alleviates MASLD by modulating gut microbial sphingolipids. This study provided novel insights into the indispensable gut microbiota for HSK31679 treatment, which revealed microbial GCS may serve as its prognostic biomarker of MASH treatment, as well as the new target for further strategies of microbiota-based MASH therapeutics. Impact and implications Remarkable heterogeneity of individual clinical efficacy of THR-β agonists and their interferences with microbiome in host hepatoenteral circulation are poorly understood. In our current germ-free mice models and randomized, double-blind multiple-dose cohort study, we identified microbial GCS as the prognostic biomarker of HSK31679 treatment, as well as the new target for further strategies of microbiota-based MASLD therapeutics. |
Variation in intention-to-treat survival by MELD subtypes: all models created for end-stage liver disease are not equal. For equivalent listing practices, registrants with MELD-Cr subtype have lower ITT survival. MELD subtype may serve as a more sophisticated variable for dynamic assessment of risk of mortality, to inform models for organ allocation. Impact and implications The MELD score is an excellent predictor of waitlist mortality; however, our work highlights that the driver of a patient's score MELD score matters and particularly those driven by elevated creatinine have a lower 1-year ITT mortality. The 1-year ITT mortality is also lower for women compared to men within the Cr-dominant subtype. These results are important for physicians and patients undergoing LT evaluation as creatinine may serve as a marker of prognosis and even if the creatinine improves the prognosis remains poor, necessitating discussion about alternative pathways for transplant. Our work also highlights that the type of kidney injury matters, in that those AKI were more likely to die or remain on the waitlist compared to those with CKD within the creatinine dominant subtype. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
|---|
| Clin Gastroenterol Hepatol |
| Endosc Int Open |
Green endoscopy, one step toward a sustainable future: Literature review. This review aims to summarize current data regarding the impact of endoscopy on GHG emissions and possible strategies to mitigate this phenomenon. Further, we aim to promote the evolution of a more sustainable "green endoscopy". |
| Gastrointest Endosc |
| Gut |
Artificial intelligence applied to 'omics data in liver disease: towards a personalised approach for diagnosis, prognosis and treatment. Given the substantial global burden of chronic liver diseases, it is imperative that multicentre collaborations be established to generate large-scale omics data for early disease recognition and intervention. Exploring advanced AI methods is also necessary to maximise the potential of these datasets and improve early detection and personalised treatment strategies. |
Emerging role of environmental pollutants in inflammatory bowel disease risk, outcomes and underlying mechanisms. The narrative review of preclinical studies suggests several overlapping mechanisms underlying these associations, including increased intestinal permeability, systemic inflammation and dysbiosis. A consolidated understanding of the impact of environmental exposures on IBD risk and outcomes is key to the identification of potentially modifiable risk factors and to inform strategies towards prediction, prevention and mitigation of IBD. |
| J Hepatol |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
|---|
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Endosc Int Open |
|---|
| Gastrointest Endosc |
| Gut |
| J Hepatol |